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'Doing things differently'--working towards distributed responsibility within memory assessment services.

Sean Page1, Kevin Hope, Chris Maj

  • 1Memory Assessment Service for Manchester, University of Manchester, Manchester, UK. sean.page@mhsc.nhs.uk

International Journal of Geriatric Psychiatry
|April 8, 2011
PubMed
Summary

Allied Health Professionals (AHPs) accurately diagnosed dementia in initial assessments, showing high accuracy compared to formal multidisciplinary teams. This suggests AHPs can effectively detect early cognitive impairment in memory clinics.

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Area of Science:

  • Gerontology
  • Neurology
  • Psychiatry

Background:

  • Early and accurate diagnosis of dementia is crucial for timely intervention and management.
  • Memory clinics utilize multidisciplinary teams (MDTs) for comprehensive patient assessment.
  • Allied Health Professionals (AHPs) play a significant role in patient assessment within healthcare settings.

Purpose of the Study:

  • To compare the diagnostic accuracy of initial hypotheses by AHPs with formal MDT formulations for dementia.
  • To evaluate the effectiveness of AHPs in detecting cognitive impairment in a memory assessment service.

Main Methods:

  • Prospective analysis of 90 consecutive referrals to a secondary care memory clinic over 3 months.
  • Home-based and clinic-based assessments conducted by AHPs (mental health nurses, occupational therapists, social workers).
  • Comparison of AHP initial diagnoses with subsequent formal MDT diagnoses, including investigations, neuropsychological tests, and brain imaging.

Main Results:

  • Dementia was diagnosed in 64.4% of patients by the MDT (Alzheimer's, mixed, vascular subtypes).
  • AHPs demonstrated high accuracy in detecting dementia (91% accuracy, Kappa 0.81, sensitivity 0.88, specificity 0.97).
  • Individual AHP professional groups showed diagnostic accuracy ranging from 88% to 93%.

Conclusions:

  • Structured initial assessments by AHPs in memory services are accurate for diagnosing cognitive impairment.
  • Distributed responsibility among AHPs offers a viable strategy for early dementia detection.
  • AHPs' diagnostic capabilities support their integration into early dementia identification pathways.